Ebola Situation Report – 21 October 2015
No confirmed cases of Ebola virus disease (EVD) were reported in the week to 11 October. This is the second consecutive week with zero confirmed cases. However, 150 registered contacts remain under follow-up in Guinea, of which 118 are high risk, and an additional 259 contacts remain untraced. There remains a near-term risk of further cases among both registered and untraced contacts.
In Sierra Leone, 2 high-risk contacts associated with the 2 most recently active chains of transmission in the country were lost to follow-up and have not yet been found.In addition, a patient who was reported as a case in the United Kingdom on 29 December 2014, and who later recovered, was hospitalised on 6 October in the United Kingdom after developing late EVD-related complications. As of 13 October, 62 close contacts have been identified in the UK for follow-up.
Case incidence has remained at 5 confirmed cases or fewer per week for 11 consecutive weeks. Over the same period, transmission of the virus has been geographically confined to several small areas in western Guinea and Sierra Leone, marking a transition to a distinct, third phase of the epidemic. A refined phase-3 response coordinated by the Interagency Collaboration on Ebola will build on these measures to drive case incidence to zero, and ensure a sustained end to EVD transmission. Enhanced capacity to rapidly identify a reintroduction (either from an area of active transmission or from an animal reservoir), or re-emergence of virus from a survivor, improved testing and counselling capacity as part of a comprehensive package to safeguard the welfare of survivors, and the increased use of innovative technologies—from vaccines to rapid diagnostic tests—are central to the phase-3 response framework.
A total of 150 contacts remain under follow-up in the Guinean prefecture of Forecariah, of which 118 are high risk. All contacts are associated with a single chain of transmission centred on the Ratoma area of the capital, Conakry. In addition, 259 contacts in Guinea have been identified but have so far not been traced. Most of these untraced contacts are from Conakry and Forecariah. The 4 most recent cases in Guinea, which were reported on 26 and 27 September from 2 villages in the sub-prefecture of Kaliah, Forecariah, were infected by a 10-year-old girl from Conakry who was an unregistered contact of a probable case linked to the Ratoma chain of transmission.
Sierra Leone reported no confirmed cases for the fourth consecutive week. All contacts linked to the country’s 2 most recently active chains of transmission, Bombali and Kambia, have now completed 21-day follow-up. In addition, the last case to receive treatment was discharged from an Ebola treatment centre in Kambia on 26 September. However, 2 high-risk contacts—one from Bombali and one from Kambia—remain untraced. Efforts to trace these contacts will continue until 42 days have elapsed since the last reported case in each district.
Robust surveillance measures are essential to ensure the rapid detection of any reintroduction or re-emergence of EVD in currently unaffected areas. Nine operational laboratories in Guinea tested a total of 725 new and repeat samples in the week to 4 October (the most recent week for which data are available from Guinea and Liberia). In Liberia, 928 new and repeat samples were collected tested in the 4 operational laboratories in the week to 4 October. 1654 new samples were collected in Sierra Leone and tested by 9 operational laboratories in the week to 11 October.
COUNTRIES WITH WIDESPREAD AND INTENSE TRANSMISSION
- Since the beginning of the outbreak there have been a total of 28 454 reported confirmed, probable, and suspected cases of EVD in Guinea, Liberia, and Sierra Leone up to 11 October, with 11 297 reported deaths (this total includes reported deaths among probable and suspected cases, although outcomes for many cases are unknown). No new cases were reported in the week to 11 October.
- The total number of confirmed cases is similar in males and females. Compared with children (people aged 14 years and under), adults aged 15 to 44 years of age are approximately four times more likely to be affected in Guinea and Liberia, and three times more likely to be affected in Sierra Leone. Adults aged 45 years and above are approximately five times more likely to be affected in Guinea, and approximately four times more likely in Liberia and Sierra Leone.
- No new health worker infections were reported in the week to 11 October. Since the start of the outbreak a total of 881 confirmed health worker infections have been reported in Guinea, Liberia, and Sierra Leone; there have been 513 reported deaths.
For more info and updates about Ebola situation see: http://apps.who.int/ebola/current-situation/ebola-situation-report-14-october-2015